Background: Heparin-induced thrombocytopenia (HIT) syndrome is an immune-mediated disorder producing thrombocytopenia and thrombosis, with or without prior exposure to heparin. Although avoidance of heparin products and non-heparin anticoagulants are used, immune-based therapies including intravenous immunoglobulin have been tried when the thrombocytopenia persists or there is breakthrough thrombosis. We sought to systematically review and analyze the [...]

Background: Heparin-Induced Thrombocytopenia (HIT) is a rare (0.1-1% of heparinized medical patients) but devastating (up to 10% mortality) side-effect of heparin administration[1].  In thrombocytopenic patients, the pre-test probability of HIT is estimated by the validated “4Ts Score”, which is used to risk-stratify patients into Low (0-3 points), Intermediate (4-5 points), and High (6-8 points) likelihoods [...]

Case Presentation: A 56-year-old female with a history of a deep vein thrombosis (DVT) during pregnancy and dementia presented with dyspnea and acute hypoxemia. Shortly thereafter, she developed persistent fevers and acute encephalopathy. Initial testing, including lumbar puncture, chest x-ray, multiple blood cultures, urine cultures, respiratory cultures, and RPR were all unremarkable. CT head was [...]

Case Presentation: A 46-year-old female presented with a 2-day history of shortness of breath, pleuritic chest pain and lower extremity swelling while taking low-molecular weight heparin (LMWH). One month prior she was diagnosed with a left lower extremity DVT after a hysterectomy. She was treated with LMWH with a planned transition to rivaroxaban. Medical history [...]

Case Presentation: A 66 year old female with a past medical history of hypertension (HTN), hyperlipidemia (HLD) and coronary artery disease (CAD) presented to the hospital for an elective three-vessel coronary artery bypass graft involving the left internal mammary artery to left anterior descending artery, saphenous vein graft (SVG) to the obtuse marginal artery, and [...]

Case Presentation: The patient is a 66-year-old female with a past medical history of asthma-COPD overlap (ACO) with recent exacerbation who presented with sudden-onset severe dyspnea. Patient was intubated for ACO exacerbation three weeks prior to admission and was started on heparin for deep vein thrombosis prophylaxis with platelet at 293, 000/microliter. At the rehabilitation [...]

Case Presentation: A 74-year-old woman with type II diabetes mellitus, chronic hypertension, and neuropathy, presented to the hospital following a 9-day course of chest and back pain. She was found to have a late-presenting anterolateral myocardial infarction and was transferred to a cardiac ICU after developing cardiogenic shock secondary to a ventricular septal rupture. An [...]